Uploaded on

 

More in: Business , Technology
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
751
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
62
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. www.ibms.org THE INSTITUTE OF BIOMEDICAL SCIENCE Record of Laboratory Training for the Specialist Diploma in Virology Please address any queries to: THE INSTITUTE OF BIOMEDICAL SCIENCE 12 Coldbath Square London EC1R 5HL Tel. No. 020 7713 0214; Fax. 020 7837 3286 Email: mail@ibms.org
  • 2. 1
  • 3. 2
  • 4. Personal Record Name: Degree Qualification(s): Awarding Institution(s): Date(s) Obtained: IBMS Membership Number: IBMS Membership Grade: HPC Registration Number: Date of HPC Registration: Employment Address: Telephone Number: Date Specialist Training Commenced: Name of Training Officer: Secondment Details Site Dates of Secondment Reasons for Secondment 3
  • 5. 4
  • 6. Training Review Reviewed by Date Comments 5
  • 7. 6
  • 8. CONTENTS 1. Introduction 12 2. Use of Portfolio 18 3. Laboratory Based Training 22 4. Assessment Procedure 26 5. Definitions 32 6. Generic To All Disciplines 34 6.1 Professional Roles and Relationships 35 Be able to understand and apply good professional practice in partnership with other professionals, support staff, patients, and service users. 6.2 Health and Safety 39 Be able to understand and apply health and safety requirements. 6.3 Receipt and Processing of Samples 43 Be able to understand and apply the correct procedures for the handling of specimens before, during and after analysis. 6.4 Laboratory Computer System 49 Be able to use the main laboratory computer system in accordance with service requirements. 6.5 Laboratory Equipment 53 Be able to maintain and operate equipment used in the preparation and analysis of samples. 6.6 Quality Assurance 57 Be able to understand and apply quality procedures throughout the laboratory. 7
  • 9. 7. Discipline Specific: Virology 62 7.1 Standard Laboratory Procedures 63 7.1a Immunoassays 7.1b Agglutination Assays 7.1c Immunofluorescence 7.1d Neutralisation Assays 7.1e Molecular Techniques 7.1f Immunoblot Assays 7.1g Electrophoretic and Gel Diffusion 7.1i Cell culture techniques 7.1j Virus Identification 7.1k Complement Fixation Tests 7.1l Electron Microscopy 7.1m Animal and Egg Culture 7.2 Respiratory Virus Infections 89 7.2a Diagnostic Algorithm 7.2b Immunological Investigations 7.2c Detection of Antigen and Replication Virus 7.2d Molecular investigations 7.3 Enteric Virus Infections 99 7.3a Diagnostic algorithm 7.3b Immunological Investigations 7.3c Electron Microscopy 7.3d Molecular investigations 7.4 Sexually Transmitted Diseases 109 7.4a Diagnostic algorithm 7.4b Immunological Investigations 7.4c Electron Microscopy and Cell Culture 7.4d Molecular Investigations 7.5 Infections in Pregnancy (Pre- and Post Delivery) 119 7.5a Diagnostic Algorithm 7.5b Immunological Investigations 7.5c Molecular Techniques 7.6 Neurological disease including Prion disease 127 7.6a Diagnostic Algorithm 7.6b Immunological and Molecular Techniques 7.6c Electron Microscopy 7.7 Vesicular and Red Rashes and Systemic infections 135 7.7a Diagnostic Algorithm 7.7b Immunological Techniques 7.7c Electron Microscopy and Cell Culture 7.7d Molecular Techniques 7.8 Blood-borne Virus Infections 145 7.8a Diagnostic Algorithm 7.8b Immunological Techniques 8
  • 10. 7.8c Molecular Techniques 7.9 Investigation of Viral Hepatitis 153 7.9a Diagnostic Algorithm 7.9b Immunological Techniques 7.9c Molecular Techniques 7.10 Infections in Neonates and Infants 161 7.10a Diagnostic algorithm 7.10b Immunological Techniques 7.10c Electron Microscopy and Cell Culture 7.10d Molecular Techniques 7.11 Immunocompromised Patients 171 7.11a Diagnostic algorithm 7.11b Immunological investigations 7.11c Electron Microscopy and Cell Culture Techniques 7.11d Molecular Techniques 7.12 Travel Related and Exotic Infections. 181 7.12a Diagnostic Algorithm 7.12b Immunological investigations 7.12c Electron Microscopy Techniques 7.12d Molecular Techniques 7.13 Infection Control 191 7.13a Infection Control Procedures 7.14 Application of pre and post exposure prophylaxis and vaccination in virology 195 7.14a Principles of pre and post exposure prophylaxis 7.14b Principles of vaccination 7.14e Indications for vaccination in the general community 7.15 Application of methods for antiviral treatment and resistance in virology 203 7.15a Principles of anti viral therapy 7.15b Principles of viral load monitoring 7.15c Principles of anti viral resistance testing 7.16 Application of methods for investigation of environmental samples for virology 211 7.16a River and water samples 7.16b Food samples 7.16c Air and aerosol sampling 7.16d Testing procedures to detect the presence of fomites 9
  • 11. 10
  • 12. 1. Introduction INSTITUTE OF BIOMEDICAL SCIENCE 11
  • 13. 12
  • 14. 1. INTRODUCTION To comply with several Department of Health (DH) initiatives, registered practitioners are expected to provide evidence of fitness to practice that can be independently assessed. This record of laboratory training (training portfolio) and the supporting evidence of achievement will be used by the Institute of Biomedical Science in determining eligibility for the award of a specialist diploma; by higher education institutions in assessing work-based learning and accredited prior experiential learning for postgraduate qualifications; or by employers in determining which of the National Occupational Standards (NOS) and Agenda for Change criteria have been achieved when considering promotion. This portfolio for specialist training will enable a biomedical scientist to build on their knowledge, skills and competencies at postgraduate level and reflect on, consolidate and develop specialist knowledge and competencies for employment as a specialist practitioner in biomedical science in the health services of the UK. In order to be awarded an Institute Specialist Diploma the individual must be a corporate member of the Institute and have completed the Institute’s Specialist Training Portfolio in accordance with the Institute’s instruction. The portfolio is not available to Affiliate members of the Institute or individuals undertaking pre- registration training. Individuals awarded the Specialist Diploma will be able, at threshold level, to: i) Work in accordance with good professional practice in partnership with other professionals, support staff, patients and service users. ii) Demonstrate an understanding and application of health and safety requirements. iii) Undertake the correct procedures for the handling of specimens, before, during and after analysis. iv) Use the main laboratory computer system in accordance with service requirements. v) Maintain and operate equipment used in the preparation and analysis of samples. vi) Perform a range of laboratory tests without immediate supervision and demonstrate an understanding of the scientific basis for tests and the disease processes under investigation. vii) Demonstrate awareness of factors affecting sample integrity, risks associated with the sample reagents, or method and other tests indicated by the outcome of the analysis. viii) Be able to understand and apply principles of quality control and quality assurance. The training portfolio for the Institute’s Specialist Diploma is available to corporate members of the Institute and is issued on application to the Institute with the required payment, which is inclusive of the end point assessment. Applicants must be working in an Institute approved training laboratory. 13
  • 15. During completion of the portfolio, biomedical scientists will be gathering evidence of continuing professional development (CPD) and competence to practice. This meets the fundamental requirements of continuing registration with the HPC, i.e. compliance with the following areas: • Professional autonomy and accountability • Professional relationships • Identification and assessment of health and social care needs • Formulation and delivery of plans and strategies for meeting health and social care needs • Critical evaluation of the impact of, or response to, the registrant’s actions • Knowledge, understanding and skills The National Occupational Standards (NOS) for healthcare scientists have been incorporated into the Institute’s qualification framework for Specialist and Higher Specialist Diplomas. The standards that are generic to all disciplines are: A Use of equipment B Developing protocols, procedures and methods C Handling of specimens D Interpret results and provide clinical results E Maintain a safe and secure working environment F Management G Training and professional development H Research and development I Patient care J Advice on healthcare services Together with discipline-specific NOS standards, these are used as a framework for the knowledge and competence statements, and for the sectioning of this training portfolio: Section 6 Is generic to all disciplines and defines training leading to competence at the level of a specialist practitioner in service delivery, health and safety, management, quality assurance, the use of equipment, and sample preparation, covered in relevant NOS functions of A, B, C, E, F and G. Section 7 Covers the range of tests appropriate to specific NOS functions related to specialist practice. The portfolio also maps to the Knowledge and Skills Framework (KSF), which will be an appraisal tool used by employers for identifying education and training needs. The analyses covered in this training portfolio are those performed by most laboratories in the UK but some might not be performed in the candidate’s own laboratory. However, knowledge of all the analyses is required, even if practical competence to perform them cannot be demonstrated, as this will express the ability of the biomedical scientist to operate at the specialist level. There may be other tests the training laboratory includes in its basic repertoire and therefore requires the individual to be competent in. These can be recorded in the reflective log at the end of each sub-section. 14
  • 16. Whilst the observation of practical skills and assessment of competence are specific to each of the tests or techniques, essays and case study evidence can be used to demonstrate knowledge and can cover several tests or techniques. The essays, case studies, or other evidence of knowledge may be acquired during formal study for a postgraduate award or as part of an internal training regime. Reference to ‘a range of sample types’ can include blood, serum, plasma, urine, CSF, etc, but also includes demonstration of competence in assessing the suitability of the sample under investigation, for example lipaemic, inadequate, haemolysed, inappropriately labelled, transported, or stored samples within a specific sample type. PLEASE NOTE: Whilst the award of a higher degree is not a prerequisite for the award of a Specialist Diploma there is the opportunity to integrate the two where possible. For example, it is hoped that the in-service training undertaken to complete this portfolio will be recognised by higher education institutions under the category of work-based learning and accrue academic credit towards an M level qualification. Equally, the formal education and assessments undertaken as part of a Masters degree will provide evidence that can be used in this portfolio. 15
  • 17. 16
  • 18. 2. Use of Portfolio INSTITUTE OF BIOMEDICAL SCIENCE 17
  • 19. 18
  • 20. 2. USE OF PORTFOLIO 2.1 Only the Institute’s Specialist Portfolio can be used for the purpose of recording the training of a biomedical scientist for the Institute’s award of a Specialist Diploma. 2.2 The laboratory training officer (or a suitable deputy) and the individual undertaking training must date and sign when the training was completed. 2.3 The portfolio will contain evidence that candidates have applied knowledge, comprehension and analytical skills gained at undergraduate level to the (new) situation in which they work. 2.4 They will demonstrate that they can relate knowledge from several areas, draw conclusions and reflect on their own performance as an independent professional learner, thus meeting the requirements for CPD. 2.5 The portfolio will contain a completed and signed record of laboratory training in the designated speciality, together with a reflective commentary on the learning experience and demonstration of competence. 2.6 Additional evidence of training and internal assessment of competency will support the Specialist Portfolio; with appropriate cross-referencing to show which aspect of knowledge or skill acquisition is supported. This may include: copies of quality control logs maintenance schedules, audit trail results, essays, notes, case studies, Journal Based Learning (JBL) and PowerPoint presentations. 2.7 A signed statement must be provided by the laboratory manager, which indicates the laboratory’s repertoire and analyses that a specialist practitioner working in that laboratory would be expected to perform without supervision. 2.8 The portfolio is the property of the individual and it will form an important part of the registrant’s portfolio of training activity. 19
  • 21. 20
  • 22. 3. Laboratory Based Training INSTITUTE OF BIOMEDICAL SCIENCE 21
  • 23. 22
  • 24. 3. LABORATORY BASED TRAINING 3.1 To permit eligibility for the award of a Specialist Diploma, in-service training must demonstrate competence and experience in the stated procedures as ‘fitness to practice’ as a specialist in the individual’s chosen discipline. 3.2 Suitable training can be obtained only by working in a laboratory approved by the Institute. Several trainers may be involved and it is essential that all training is co-ordinated and carried out under the control of a designated training co-ordinator or training officer. 3.3 A training schedule must be prepared and adhered to in accordance with the Institute’s Standards for Training in the Laboratory and also to meet CPA standard B9.1. 3.4 The training co-ordinator/officer should ensure that regular reports on progress from trainers are reviewed at least once a month, discussed with the individual being trained, and documented. The object of these review pages is to ensure that a constructive, detailed, and contemporaneous record is kept, on which future training activities can be based. 3.5 Competence must be achieved by coverage of all modules within the chosen disciplines. Some tests may be considered as ‘core’ and require demonstration of practical competence. Other tests may only require demonstration of knowledge and understanding that would be applied to the practical situation, if an investigation were considered to be outside the core repertoire of a routine laboratory. 3.6 Short periods of secondment to other Institute approved laboratories may supplement training in order for the individual to gain additional practical skills and experience. 3.7 Candidates may undertake a selection of the following activities to complete the “Record of Laboratory Training for the Specialist Diploma” and prepare for assessment: i) Work-based training. ii) Continuing professional development (CPD). iii) Journal Based Learning (JBL). iv) Essays and case studies. v) Tutorials. vi) Taught MSc courses at a Higher Educational Institution. vii) Taught specialist distance-learning courses. 3.8 Evidence of achievement is based on observation and questions set by the trainer or individual pieces of work related to the knowledge statements of each module and based on the examples of evidence listed in Section 5 (page 30). 23
  • 25. 24
  • 26. 4. Assessment Procedure INSTITUTE OF BIOMEDICAL SCIENCE 25
  • 27. 26
  • 28. 4. ASSESSMENT PROCEDURE 4.1 On completion of training in accordance with the requirements of the Specialist Portfolio, the candidate’s employer (laboratory manager or training officer) should apply to the Institute for the appointment of a visiting external assessor. The appointed external assessor will be instructed to contact the laboratory in accordance with the Institute’s assessment procedure. 4.2 The aims of the assessment procedure are to: • Independently verify that competence has been met • Ensure consistency between disciplines and between laboratories • Check that professional body guidelines and criteria are applied nationally • Reassure the employer that their training is to the appropriate standard • Disseminate areas of good practice • Highlight areas of unsatisfactory practice 4.3 There will be a meeting between assessor and candidate during which the assessor establishes confidence in the understanding, ability and practice of the candidate. A key component of this will be a twenty-minute presentation during which the candidate presents a review of their post-registration training experience and current issues important within their discipline. 4.4 The external assessor will establish completion of the portfolio as a record of training in the candidate’s ‘home’ discipline. If more specialist areas are not undertaken in the candidates employing laboratory, demonstration of appropriate knowledge and understanding rather than practical competence is acceptable. 4.5 The external assessor will review the reflective reports associated with each module and interview the candidate on aspects of their work raised in the commentary and presentation. The discussion should be supported by examples contained within an accompanying portfolio of evidence. 4.6 The candidate will conduct the external assessor on a laboratory tour during which further aspects of the candidates training and work are explored. 27
  • 29. 28
  • 30. 5. Definitions INSTITUTE OF BIOMEDICAL SCIENCE 29
  • 31. 30
  • 32. 5. DEFINITIONS The following terminology is used throughout the portfolio. BE AWARE OF A general appreciation of the content of the key task. KNOW A working knowledge of the facts associated with the key task. UNDERSTAND Thorough comprehension of the principles and concepts of the content of the key task. COMPETENT Has the ability to perform a test or procedure to a set standard on more than one occasion, in a consistent manner and with minimal or no supervision, together with a thorough comprehension of the principles and concepts of the content of the key task. EVIDENCE OF The Institute’s Specialist Diploma will only be awarded if there is ACHIEVEMENT supporting evidence that competence has been achieved. This evidence will be presented as a portfolio, logically and cross- referenced to the relevant module or sections it supports. Suggested evidence for inclusion: • Audit trail results • Annotated photomicrographs • Copies of QC logs • Copies of EQA records • Maintenance schedules • Error logs • Essays, (this may include essays submitted at CPD or as part of academic study) • Quizzes • Notes • PowerPoint presentations • Annotated kit inserts • Annotated journal papers CoC Health Professions Council Code of Conduct. CPA Clinical Pathology Accreditation HPC Health Professions Council KSF Knowledge and Skills Framework. NOS National Occupational Standards. SOP Standard Operating Procedure. SoP Health Professions Council Standards of Proficiency. 31
  • 33. 32
  • 34. 6. Generic To All Disciplines Section 6 is generic to all disciplines and defines training leading to competence at the level of a specialist practitioner in relation to professional practice, service delivery, processing of samples, use of equipment, IT and quality assurance. It reflects the HPC standards of proficiency and can be used as evidence of continuing professional development in a specialist discipline. INSTITUTE OF BIOMEDICAL SCIENCE 33
  • 35. 34
  • 36. Section 6. GENERIC TO ALL DISCIPLINES 6.1 Professional Roles and Relationships Be able to understand and apply good professional practice in partnership with other professionals, support staff, patients, and service users. KNOWLEDGE • Know limits of own professional practice and referral mechanisms. • Understand the principles of team working, leadership and the significance of individual contributions in the laboratory team. • Understand the principles of effective communication within the laboratory and to service users in order to achieve the aims of the service. • Be aware of the roles and relationships of other professional groups in the clinical setting. • Be aware of the factors influencing the effectiveness of the laboratory service. • Know how and where to access information of relevance to the request for advice. COMPETENCE You must be able to: a) Clarify your role within the laboratory and expectations of your contribution. b) Take relevant action to co-ordinate your contribution with the requirements of others. c) Co-operate effectively with service users by providing appropriate advice and assistance. d) Demonstrate good interpersonal skills and the ability to sustain good working relationships within the laboratory team and with service users. e) Demonstrate good verbal and written communication skills through all stages of the biomedical process. f) Ensure that work outside the scope or ability of your practice is passed to the appropriate individual or professional group. g) Respond to routine requests with accurate and current information. 35
  • 37. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that competence has been successfully achieved on more than one occasion. Biomedical scientists completing the Institute’s Registration Portfolio to attain a Certificate of Competence and HPC registration will already have covered the majority of this section. It is included here to demonstrate continued competence and continuing professional development (CPD) and to standardise with the competence requirement for a registered practitioner. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 36
  • 38. Reflective Log - Professional Roles and Relationships 1. Profession specific meetings attended. Duration of training From To 2. How have you applied your training to your current role? 3. How will you apply the learning in your future work? 4. Future development possibilities. 37
  • 39. 38
  • 40. 6.2 Health and Safety Be able to understand and apply health and safety requirements. KNOWLEDGE • Be aware of current safety legislation relevant to the laboratory, including the USDAW “six pack” (that substantiates the Health and Safety at Work Act 1974) and other regulations including: o Management of Health and Safety at Work Regulations o Manual Handling Operations Regulations o Display Screen Equipment Regulations o Workplace (Health, Safety and Welfare) Regulations o Provision and Use of Work Equipment Regulations o Personal Protective Equipment Regulations o RIDDOR o COSHH • Understand the responsibilities of the employer and employee defined in the Health and Safety at Work Act and other appropriate legislation. • Be aware of the contents of the laboratory safety manual and local safety procedures. • Understand the principles and limitations of hazard analysis, monitoring and management. • Understand and know appropriate waste routes for various types of waste and alternatives in different situations. • Know the types of safety equipment and their proper use. COMPETENCE You must be able to: a) Locate relevant health and safety procedures, guidelines, and documents in the laboratory. b) Respond to hazardous situations in an appropriate and safe manner. c) Perform tasks in accordance with H&S guidelines. d) Select and use appropriate safety equipment. e) Perform a risk assessment and a COSHH assessment. 39
  • 41. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that competence has been successfully achieved on more than one occasion. Biomedical scientists completing the Institute’s Registration Portfolio to attain a Certificate of Competence and HPC registration will already have covered the majority of this section. It is included here to demonstrate continued competence and continuing professional development (CPD) and to standardise with the competence requirement for a registered practitioner. Supporting evidence should be collected and prepared as indicated below as a portfolio. i) Answered questions set by the trainer regarding the location and use of the safety manual and safety equipment in the laboratory. Date of completion: Trainer’s name: Trainer’s signature: ii) Provided evidence of attendance at Trust fire safety and manual handling training sessions. Date of completion: Trainer’s name: Trainer’s signature: iii) Provided a copy of a risk assessment report and COSHH assessment report carried out under the guidance of the safety officer. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 40
  • 42. Reflective Log - Health & Safety 1. Safety lectures/course attended. Duration of training. From To 2. How have you applied your training to your current role? 3. How will you apply the learning in your future work? 4. Future development possibilities. 41
  • 43. 42
  • 44. 6.3 Receipt and Processing of Samples Be able to understand and apply the correct procedures for the handling of specimens before, during and after analysis. KNOWLEDGE • Understand the laboratory procedure for test requesting and sample receipt. • Understand the need for patient confidentiality and the implications of the Data Protection Act. • Be aware of collection techniques appropriate to the sample under investigation and the sample requirements for particular tests and procedures to employ when requirements are not met. • Understand about universal precautions for the handling of all samples including the hazards posed by ‘High Risk’ samples and be aware of the procedures implemented in their safe handling. • Understand the laboratory procedures for specimen preparation prior to laboratory investigation. • Understand the laboratory procedure for the storage of samples. • Be aware of particular storage requirements for some tests. • Be aware of guidelines for long-term storage of samples for various patient groups. • Understand the laboratory procedure for the safe disposal of biological samples. • Be aware of legislation and regulations covering the transport of samples. 43
  • 45. COMPETENCE You must be able to: a) Locate information on the sample requirements for a particular test from Laboratory Handbook and SOPs. b) Safely receive, handle and move samples according to local procedures. c) Confirm minimum compliant data set for acceptable patient ID and can confirm that patient details and test request from request form match those on the sample. d) Take appropriate action if the patient details are not completed correctly or are incomplete. e) Confirm sample type is appropriate to the test being requested, if not, take appropriate action. f) Perform sample preparations steps relevant to the investigation. g) Store samples appropriately and safely in line with long term storage guidelines. h) Arrange for referral of samples to specialist centre. i) Dispose of samples appropriately and safely. 44
  • 46. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that competence has been successfully achieved on more than one occasion. Biomedical scientists completing the Institute’s Registration Portfolio to attain a Certificate of Competence and HPC registration will already have covered the majority of this section. It is included here to demonstrate continued competence and continuing professional development (CPD) and to standardise with the competence requirement a registered practitioner. Supporting evidence should be collected and prepared as a portfolio. i) Observed by trainer to prepare samples for analysis. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the receipt, preparation, referral (if appropriate), storage and disposal of samples. Date of completion: Trainer’s name: Trainer’s signature: iii) Described the range of techniques used to prepare samples for routine analysis. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 45
  • 47. 46
  • 48. Reflective Log - Receipt and Processing of Samples 1. Range of sample types. Duration of training. From To 2. How have you applied your training to your current role? 3. How will you apply the learning in your future work? 4. Future development possibilities. 47
  • 49. 48
  • 50. 6.4 Laboratory Computer System Be able to use the main laboratory computer system in accordance with service requirements. KNOWLEDGE • Be aware of the basic principles of Information Technology (IT). • Be aware of interfacing with major laboratory equipment, hospital IT and GP links. • Where applicable, understand the user interface for: ο booking-in sample requests ο generation of work lists ο enquiries ο basic statistics generation ο report generation • Understand the laboratory procedure for test requesting and sample receipt. • Understand the need for patient confidentiality and the implications of the Data Protection Act. COMPETENCE You must be able to: a) Book-in sample test requests and patient details. b) Generate work lists (if applicable). c) Interrogate the laboratory computer system to: o retrieve specific sample results o obtain additional information and test results to help in current analysis o retrieve cumulative data on a single patient, groups of patients, or QC o Generate laboratory report. 49
  • 51. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that competence has been successfully achieved on more than one occasion. Biomedical scientists completing the Institute’s Registration Portfolio to attain a Certificate of Competence and HPC registration will already have covered the majority of this section. It is included here to demonstrate continued competence and continuing professional development (CPD) and to standardise with the competence requirement for a registered practitioner. Supporting evidence should be collected and prepared as indicated below as a portfolio. i) Answered questions set by the trainer on the use of the laboratory computer system. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 50
  • 52. Reflective Log - Laboratory Computer System 1. Type of laboratory computer system. Duration of training. From To 2. How have you applied your training to your current role? 3. How will you apply the learning in your future work? 4. Future development possibilities. 51
  • 53. 52
  • 54. 6.5 Laboratory Equipment Be able to maintain and operate equipment used in the preparation and analysis of samples. KNOWLEDGE • Understand the principles and limits of operation of named laboratory equipment. • Be aware of the range of application for the main laboratory analysers or equipment used in routine preparation and analysis of samples. • Understand the use of test profiles and the profiles available. • Know how to use calibration and control materials. • Know the physical, chemical and biological hazards associated with laboratory equipment. COMPETENCE You must be able to: a) Perform the routine maintenance in accordance with laboratory procedures. b) Prepare equipment for sample processing or analysis in accordance with laboratory procedures. c) Monitor operation of equipment in accordance with laboratory procedures. d) Complete laboratory records as required. e) Perform routine decontamination using appropriate procedure. 53
  • 55. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that competence has been successfully achieved on more than one occasion. Biomedical scientists completing the Institute’s Registration Portfolio to attain a Certificate of Competence and HPC registration will already have covered the majority of this section. It is included here to demonstrate continued competence and continuing professional development (CPD) and to standardise with the competence requirement for a registered practitioner. Supporting evidence should be collected and prepared as indicated below as a portfolio. i) Answered questions set by the trainer on principles of operation and uses of named laboratory equipment, including (where appropriate) routine preventative maintenance, calibration, and limitations of the equipment. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 54
  • 56. Reflective Log - Laboratory Equipment 1. Main Equipment Used. (eg type of automated analyser, microtome, microscope) Duration of training. From To 2. How have you applied your training to your current role? 3. How will you apply the learning in your future work? 4. Future development possibilities. 55
  • 57. 56
  • 58. 6.6 Quality Assurance Be able to understand and apply quality procedures throughout the laboratory. KNOWLEDGE • Understand the principles and application of quality control and quality assurance. • Understand the difference between vertical and horizontal audit. • Be aware of the use of quality management tools, e.g. Westgard Rules • Understand the purpose of Clinical Pathology Accreditation (UK) Ltd. • Understand the role of the Institute of Biomedical Science and Health Professions Council relevant to professional standards patient healthcare. • Be aware of the relevant codes of practice, legislation, ethical considerations and issues of confidentiality applicable to the area of laboratory investigation. COMPETENCE You must be able to: a) Describe the principles and practice of quality control procedures for named laboratory investigations. b) Describe the use of external quality assurance schemes applicable to your laboratory. c) Explain the use of Westgard rules and Levy Jennings plots. d) Conduct vertical and horizontal audits to check correct application of laboratory procedures. e) Demonstrate an understanding of the role and requirements of accreditation by CPA (UK) Ltd through the application of one’s own practice. f) Describe the different roles of the professional and regulatory organisations for biomedical scientists and demonstrate an understanding of the relevance to professional practice. g) Show awareness of need to apply relevant legislation relevant to the investigation and use of patient samples. 57
  • 59. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that competence has been successfully achieved on more than one occasion. Biomedical scientists completing the Institute’s Registration Portfolio to attain a Certificate of Competence and HPC registration will already have covered the majority of this section. It is included here to demonstrate continued competence and continuing professional development (CPD) and to standardise with the competence requirement for a registered practitioner. Supporting evidence should be collected and prepared as indicated below as a portfolio. i) Answered questions set by the trainer on relevant quality control, quality assurance and legislative practices. Date of completion: Trainer’s name: Trainer’s signature: ii) Presented evidence of a vertical and horizontal audit conducted in the workplace. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 58
  • 60. Reflective Log - Quality Assurance 1. External Quality Assurance Schemes. Duration of training. From To 2. How have you applied your training to your current role? 3. How will you apply the learning in your future work? 4. Future development possibilities. 59
  • 61. 60
  • 62. 7. Discipline Specific: Virology This section covers the range of tests appropriate to specific NOS functions related to specialist practice in Virology. The analyses covered are those performed by most laboratories in the UK but some might not be performed in the candidate’s own laboratory. However, knowledge of all the analyses is required (or awareness if the test is not performed in the laboratory), as this will express the ability of the biomedical scientist to operate at the specialist level. There may be other tests the training laboratory included in its basic repertoire and therefore requires the individual to be competent in. These can be recorded in the reflective log at the end of each sub-section. Whilst the observation of practical skills and assessment of competence are specific to each of the test or techniques, supporting evidence in the form of essays and case study evidence can be used to demonstrate knowledge and can cover several tests or techniques. The essays, case studies, or other evidence of knowledge may be acquired during formal study for a postgraduate award or as part of an internal training regime. INSTITUTE OF BIOMEDICAL SCIENCE 61
  • 63. 62
  • 64. Section 7. DISCIPLINE SPECIFIC: Virology 7.1 Standard Laboratory Procedures 7.1a Immunoassays Be able to perform immunoassay techniques on a range of sample types. KNOWLEDGE • Understand the principles and application of immunoassay techniques, including: o direct and indirect immunoassay o competitive immunoassay o capture immunoassay o solid phase and liquid phase immunoassay • Understand the use and application of detection systems including: o enzyme o enzyme amplification o immunofluorescence o chemiluminescence o radioactive • Be aware of factors affecting sample integrity and appropriate corrective action. • Be aware of specific risks associated with the reagents or method. • Understand the significance of abnormal results. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles of a variety of immunoassay techniques and the limitations of each. b) Perform routine immunoassays in accordance with laboratory procedure. c) Critically evaluate assay results. d) Follow-up positive results by confirmation. e) Complete laboratory records as required. 63
  • 65. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform immunoassay techniques in accordance with standard procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on principles and practice of immunoassay techniques. Date of completion: Trainer’s name: Trainer’s signature: iii) Described the advantages and disadvantages of a range of immunoassay techniques. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 64
  • 66. 7.1b Agglutination Assays Be able to perform agglutination assays on a range of sample types. KNOWLEDGE • Understand the principles and application of agglutination assays, including: o haemagglutination (and inhibition) o immune adherence haemagglutination o particle agglutination • Be aware of factors affecting sample integrity and appropriate corrective action. • Be aware of specific risks associated with the reagents or method. • Understand the significance of abnormal results. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles of a variety of agglutination and the limitations of each. b) Perform routine agglutination techniques in accordance with laboratory procedure. c) Critically evaluate assay results. d) Follow-up positive results by confirmation. e) Complete laboratory records as required. 65
  • 67. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform agglutination techniques in accordance with laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of agglutination techniques. Date of completion: Trainer’s name: Trainer’s signature: iii) Described the advantages and disadvantages of different agglutination techniques. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 66
  • 68. 7.1c Immunofluorescence Be able to perform immunofluoresence techniques on a range of sample types. KNOWLEDGE • Understand the principles and application of immunofluorescence techniques, including: o direct and indirect immunofluorescence o antigen detection o antibody detection • Be aware of factors affecting sample integrity and appropriate corrective action. • Be aware of specific risks associated with the reagents or method. • Understand the significance of abnormal results. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles of a variety of immunofluorescence techniques and the limitations of each. b) Perform routine immunofluorescence techniques in accordance with laboratory procedure. c) Critically evaluate assay results. d) Follow-up positive results by confirmation. 67
  • 69. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform immunofluorescence techniques in accordance with laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of immunofluorescence techniques. Date of completion: Trainer’s name: Trainer’s signature: iii) Described the advantages and disadvantages of immunofluorescence techniques. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 68
  • 70. 7.1d Neutralisation Assays Be able to perform basic neutralisation techniques on a range of sample types. KNOWLEDGE • Understand the principles of neutralisation in serology. • Know how to perform serological neutralisation assays in accordance with laboratory procedure. • Know how to interpret serological neutralisation assay results. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles of neutralisation techniques in serology. b) Perform routine neutralisation techniques in accordance with laboratory procedure. c) Critically evaluate assay results. d) Complete laboratory records as required. 69
  • 71. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform neutralisation techniques in accordance with laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of the neutralisation techniques. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 70
  • 72. 7.1e Molecular Techniques Be able to perform basic molecular techniques on a range of sample types. KNOWLEDGE • Understand the use of molecular testing for viral detection, quantitation and genotypic analysis. • Understand the use of molecular testing for antiviral resistance determinants. • Understand the use of molecular testing for epidemiological study. • Understand the principles of nucleic acid extraction. • Know the limitations of the extraction method for a range of sample types. • Understand the importance of ultra-centrifugation for concentration of nucleic acid. • Know the significance of contamination prevention in nucleic acid extraction. • Understand the principles of: o target amplification o polymerase chain reaction (PCR), RT-PCR and kinetic PCR o strand displacement assays (SDA) o nucleic acid sequence-based amplification (NASBA) o kinetic PCR o transcription mediated amplification (TMA) o Probe-Primer amplification o Ligase chain reaction (LCR) o signal amplification o branched DNA (bDNA) o hybridisation • Know the principles and practice of molecular techniques for detection of viral disease. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles of molecular techniques. b) Select molecular based assay for diagnosis, monitoring viral load, viral resistance testing and epidemiological surveillance. c) Perform a selection of routine molecular techniques in accordance with laboratory procedure. d) Critically evaluate assay results. e) Complete laboratory records as required. 71
  • 73. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform a range of molecular techniques in accordance with laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of molecular techniques. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 72
  • 74. 7.1f Immunoblot Assays Be able to perform basic immunoblot techniques on a range of sample types. KNOWLEDGE • Understand the principles and limitations of immunoblot techniques, including: o RIBA o LIA o LIPA • Know how to perform immunoblot assays and interpret results in accordance with laboratory procedure. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles of immunoblot techniques. b) Perform a selection of routine immunoblot techniques in accordance with standard laboratory procedure. c) Critically evaluate assay results. d) Complete laboratory records as required. 73
  • 75. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform immunoblot techniques in accordance with standard laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of immunoblot techniques. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 74
  • 76. 7.1g Electrophoretic and Gel Diffusion Be able to perform basic electrophoresis and gel diffusion techniques on a range of sample types. KNOWLEDGE • Understand the principles and limitations of electrophoresis and gel diffusion assays. • Know how to perform electrophoresis and gel diffusion assays. • Know how to interpret electrophoresis and gel diffusion assay results. • Know how to troubleshoot electrophoresis and gel diffusion assays. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles of electrophoretic and gel diffusion assays. b) Perform a selection of routine assays in accordance with standard laboratory procedure. c) Critically evaluate assay results. d) Complete laboratory records as required. 75
  • 77. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform electrophoretic and gel diffusion techniques in accordance with standard laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice electrophoretic and gel diffusion techniques. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 76
  • 78. 7.1i Cell culture techniques Be able to perform basic cell culture techniques. KNOWLEDGE • Understand the requirement for good aseptic technique. • Understand the origin and nature of cell line commonly used in virus isolation. • Understand the methods for preserving and recovering cell cultures. • Know how to maintain cell cultures. • Know how to perform good passage. • Know how to interpret cell culture monolayer cytopathic effects. • Understand the requirements for cell culture propagation. • Understand the requirements for incubation at different temperatures. • Know the principles of Mycoplasma detection, control and eradication from cell lines. • Know how to select different cell lines for various viral cultures. • Know how to prepare samples for inoculation of cell cultures. COMPETENCE You must be able to: a) Perform routine preservation and recovery of cell cultures including preparation of cell stocks from tissues. b) Prepare samples for inoculation of cell cultures. c) Maintain and propagate cell cultures. d) Demonstrate good passage technique. e) Prepare sterile cell culture media and viral transport medium. f) Perform sterility checks on culture media. g) Use appropriate cell culture for inoculation of different type of specimens. h) Interpret monolayer cytopathic effects. 77
  • 79. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform basic cell culture techniques in accordance with standard laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of the cell culture methods. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 78
  • 80. 7.1j Virus Identification Be able to perform basic virus identification techniques. KNOWLEDGE • Understand the need for regular medium changes of inoculated cells. • Understand the principles of neutralisation in cell culture. • Understand the principles of haemadsorption in cell culture. • Understand the principles of acid tolerance test in cell culture. • Know how to interpret cell culture monolayer cytopathic effects. • Know how to perform virus identification assays and interpret results. COMPETENCE You must be able to: a) Perform various virus identification assays in cell culture in accordance with standard laboratory procedure. b) Select required virus identification assays for appropriate disease state. c) Describe the limitations of each virus identification assay for cell culture. d) Critically evaluate assay results. 79
  • 81. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform virus identification by cell culture techniques in accordance with standard laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of the virus identification methods. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 80
  • 82. 7.1k Complement Fixation Tests Be able to perform complement fixation techniques. KNOWLEDGE • Understand the principles and limitations of complement fixation tests. • Know how to perform complement fixation tests in accordance with standard laboratory procedures. • Be aware of the application of functional complement in other techniques, including SRH. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the principles and application of complement fixation techniques. b) Perform complement fixation tests in accordance with standards laboratory procedure. c) Critically evaluate assay results. 81
  • 83. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform complement fixation techniques in accordance with standard laboratory procedure. Date of completion: Trainer’s name: Trainer’s signature: ii) Answers questions set by trainer on the principles and practice of the complement fixation methods. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 82
  • 84. 7.1l Electron Microscopy Be able to describe the use of electron microscopy techniques for the identification of common viruses. KNOWLEDGE • Understand the principles of scanning and transmission electron microscopes. • Understand the safety precautions required when use electron microscopy. • Understand the use of the ultracentrifuge for concentrating virus particles. • Be aware of the techniques used in immuno-electron microscopy. • Be aware of the techniques used to produce ultra-thin sections using the ultramicrotome. • Know how to process specimens for electron microscopy. • Know how to prepare reagents and stains used in electron microscopy. • Know principles of how to prepare Formavar and carbon coated grids. COMPETENCE You must be able to: a) Describe how to process specimens for electron microscopy. b) Describe how to prepare reagents and stains used in electron microscopy. c) Describe how to prepare Formavar and carbon coated grids. d) Recognise the morphology of the more common viruses. 83
  • 85. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the principles and practice of techniques used in the identification of viruses by electron microscopy. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 84
  • 86. 7.1m Animal and Egg Culture Be able to describe the use of animal and egg culture techniques used for virus isolation. KNOWLEDGE • Be aware of the limited use of eggs and animals for virus isolation and identification. • Be aware of the importance and use of animals for the production of vaccine, reagents and research. COMPETENCE You must be able to: a) Describe the traditional use of egg and animal culture techniques for virus isolation. b) Describe alternative methods besides the use of eggs and animals for virus isolation and identification. 85
  • 87. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the principles and practice egg and animal culture techniques for virus isolation. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 86
  • 88. Reflective Log – Standard Laboratory Procedures 1. What did you do? Summarise the laboratory techniques used as standard laboratory procedures. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 87
  • 89. 88
  • 90. 7.2 Respiratory Virus Infections 7.2a Diagnostic Algorithm Be able to describe the viral causes of respiratory infection, diagnostic investigations and control of infection. KNOWLEDGE • Understand the range of potential respiratory viruses which may infect the human respiratory tract e.g. influenza, RSV, etc. • Know the common causes of respiratory infection and appropriate investigations which should be used for diagnosis which range of tests should be used for diagnostic testing. • Know the less common causes of respiratory infection and when to consider using appropriate investigations for diagnosis tests which may be used for diagnostic testing. • Know the cyclical nature of some respiratory viral pathogens and the alert mechanisms used to establish when they should be investigated for and which tests to use. • Understand other important potential non viral respiratory infections e.g. Mycoplasma pneumoniae. • Be aware of potential respiratory virus infections that might be circulating worldwide. • Understand the requirements for appropriate samples from patients with potential respiratory virus infections such as naso-pharyngeal aspirate (NPA), brochial-alveolar lavages (BAL), sputum, nasal washings, nose and throat swabs, acute and convalescent serum. • Be aware of the procedures involved in the collection of the above sample types and understand the optimal time for collection of these samples. • Be aware of potential therapy that may be available for prophylaxis and treatment of respiratory viral infections, e.g. antivirals, immunoglobulin and vaccines. • Know which patient groups are at high risk with regard to respiratory virus infections. • Be aware of infection controls issues and measures which may be taken with regard to respiratory virus infections in hospital and within the community. COMPETENCE You must be able to: a) Describe the causes of respiratory viral infections and relevant investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how respiratory viral pathogens are transmitted and how patients with each of these infections would be managed and treated. 89
  • 91. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of respiratory viral infections and relevant investigations for diagnosis. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of respiratory viral infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 90
  • 92. 7.2b Immunological Investigations Be able to perform immunological techniques for the investigation of respiratory infection. KNOWLEDGE • Understand the principles and limitations of techniques available for the detection of respiratory viruses in samples, including: o rapid test kits o immunofluorescence • Understand the principles and limitations of techniques available for the detection of antibodies to respiratory viruses, including: o complement fixation test o enzyme immunoassay o particle agglutination • Understand the advantages and disadvantages of above methods. • Know the relevant internal and external quality procedures. COMPETENCE You must be able: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 91
  • 93. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations of respiratory viral infection in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of respiratory viral infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of respiratory viral infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 92
  • 94. 7.2c Detection of Antigen and Replication Virus Be able to perform antigen detection techniques for the investigation of respiratory infection. KNOWLEDGE • Know the principles and limitations of techniques available for the detection of respiratory viruses in a variety of samples, including: o rapid test kits o immunofluorescence o virus culture including shell vials o immunoassay • Understand the advantages and disadvantages of above methods. • Know the relevant internal and external quality procedures. COMPETENCE You must be able: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 93
  • 95. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the trainee has successfully achieved the level of competence on more than one occasion. The trainee should collect and prepare other supporting evidence indicated below as a portfolio. i) Observed by trainer to perform investigations of respiratory virus antigens in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of respiratory virus antigens. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of antigens present in respiratory viral infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 94
  • 96. 7.2d Molecular investigations Be able to perform molecular techniques to the investigation of viral respiratory infection. KNOWLEDGE • Know the principles and limitations of techniques available for the detection of respiratory viruses in a variety of samples. • Understand the advantages and disadvantages of above methods. • Know the relevant internal and external quality procedures. COMPETENCE You must be able: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 95
  • 97. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the trainee has successfully achieved the level of competence on more than one occasion. The trainee should collect and prepare other supporting evidence indicated below as a portfolio. i) Observed by trainer to perform molecular investigations of respiratory virus infection in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of respiratory virus infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 96
  • 98. Reflective Log – Respiratory Virus Infections 1. What did you do? Summarise the laboratory techniques used in the investigation of respiratory virus infections. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 97
  • 99. 98
  • 100. 7.3 Enteric Virus Infections 7.3a Diagnostic algorithm Be able to describe the viral causes of respiratory infection, diagnostic investigations and control of infection. KNOWLEDGE • Know the range of enteric viruses which may infect humans e.g. rotavirus, adenovirus, norovirus. • Be aware of other important non-viral enteric infections e.g. salmonella. • Know the common causes of viral enteric infection and which range of investigations should be used for diagnostic testing and screening purposes. • Be aware of the less common causes of enteric infection and when to consider using investigations that may be used for diagnostic purposes e.g. parasitic infections. • Understand the requirements for appropriate samples from patients with potential enteric virus infections such as faeces, rectal swabs and vomit. • Be aware of the procedures involved in the collection of the above sample types and understand the optimal time for collection of various samples. • Be aware of potential therapy that may be available for prophylaxis and treatment of enteric viral infections and rationale for use e.g. antivirals, immunoglobulin and vaccines. • Know which patient groups are at high risk with regard to enteric virus infections. • Be aware of infection controls issues and measures which may be taken with regard to enteric virus infections in hospital and within the community. COMPETENCE You must be able to: a) Describe the causes of enteric viral infections and relevant investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how enteric viral pathogens are transmitted and how patients with each of these infections would be managed and treated. 99
  • 101. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of enteric viral infections and relevant investigations for diagnosis. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of enteric viral infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 100
  • 102. 7.3b Immunological Investigations Be able to perform immunological techniques to the investigation of enteric viral infection. KNOWLEDGE • Know the principles and limitations of immunological techniques available for the detection of enteric viral infections in samples. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Understand the advantages and disadvantages of the methods. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Describe the causes of enteric viral infections and relevant investigations for diagnosis. d) Refer specimens to a specialist centre in accordance with laboratory procedures. 101
  • 103. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations of enteric viral infection in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of enteric viral infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of enteric viral infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 102
  • 104. 7.3c Electron Microscopy Be able to describe electron microscopy techniques for the investigation of enteric viral infection. KNOWLEDGE • Understand the principles and practice of electron microscopy techniques available for the detection of enteric viral infections in a variety of samples. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Be aware of internal and external quality procedures. COMPETENCE You must be able: a) Describe the application of electron microscopy to the investigation of enteric viruses. b) Recognise the morphology of the common enteric viruses. 103
  • 105. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of electron microscopy for the investigation of enteric viral infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 104
  • 106. 7.3d Molecular investigations Be able to perform molecular techniques to the investigation of enteric viral infection. KNOWLEDGE • Understand the requirements for appropriate samples from patients with suspected viral enteric infection. • Understand the principles and limitations of molecular techniques available for diagnosis of enteric viral infection. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 105
  • 107. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of enteric virus infection in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of enteric virus infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 106
  • 108. Reflective Log – Enteric Virus Infections 1. What did you do? Summarise the laboratory techniques used in the investigation of enteric virus infections. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 107
  • 109. 108
  • 110. 7.4 Sexually Transmitted Diseases 7.4a Diagnostic algorithm Be able to describe viral and non-viral causes of sexual transmitted diseases, diagnostic investigations and control of infection. KNOWLEDGE • Know the range of sexually transmitted viruses which may infect humans, including: o HSV o Molluscum contagiosum o HIV • Be aware of other important non-viral sexually transmitted infections e.g. syphilis. • Know the common causes of sexually transmitted infection and the range of investigations used for diagnostic testing and screening. • Know the less common causes of sexually transmitted infection and when to consider using investigations that may be used for diagnostic purposes. • Understand the requirements for samples from patients with potential sexually transmitted infections such as genital tract and rectal swab, urine, and blood (serum and EDTA) and optimal collection time. • Understand the sample collection techniques for the investigation of Chlamydia, vesicular STI’s, HSV or Molluscum contagiosum. • Understand potential therapy that may be available for prophylaxis and treatment of sexually transmitted infections, including antivirals, immunoglobulin and vaccines. • Know which patient groups are at high risk with regard to sexually transmitted infections. • Know about infection controls issues and measures which may be taken with regard to sexually transmitted infections. • Know the potential infection risk to the foetus. • Understand the importance of screening programmes and their role in prevention of disease. COMPETENCE You must be able to: a) Describe the causes of sexually transmitted infections and investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how sexually transmitted viral pathogens may infect humans and how patients with these infections would be managed and treated. 109
  • 111. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of sexually transmitted disease, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of sexually transmitted diseases. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating the pathogenesis and treatment of HIV infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 110
  • 112. 7.4b Immunological Investigations Be able to perform serological techniques for the investigation of sexually transmitted diseases in a range of samples. KNOWLEDGE • Know the principles and limitations of techniques available for the detection of sexually transmitted infections, including: o rapid test kits o immunofluorescence o complement fixations test o enzynme immunoassay o particle agglutination • Understand the requirement for confirmatory assays and the role of reference laboratories. • Understand the advantages and disadvantages of the methods. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform a range of immunological investigative techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Describe the causes of enteric viral infections and relevant investigations for diagnosis. d) Refer specimens to a specialist centre in accordance with laboratory procedures. 111
  • 113. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations of sexually transmitted infection in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of sexually transmitted infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of sexually transmitted infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 112
  • 114. 7.4c Electron Microscopy and Cell Culture Be able to describe the application of electron microscopy and cell culture techniques to the investigation of sexually transmitted disease. KNOWLEDGE • Understand the principles and practice of electron microscopy and cell culture techniques available for the detection of sexually transmitted infections in samples. • Understand the requirement for confirmatory assays and the role of reference laboratories • Understand the advantages and disadvantages of the methods. • Be aware of internal and external quality procedures. COMPETENCE You must be able: a) Describe the application of electron microscopy and cell culture techniques to the investigation of sexually transmitted infections. b) Recognise the morphology of the common sexually transmitted viruses. 113
  • 115. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of electron microscopy and cell culture techniques for the investigation of sexually transmitted infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 114
  • 116. 7.4d Molecular Investigations Be able to perform molecular techniques for the investigation of sexually transmitted diseases on a variety of patient samples. KNOWLEDGE • Understand the principles and limitations of molecular techniques available for diagnosis of sexually transmitted infections in a range of samples. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 115
  • 117. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of sexually transmitted infections in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of sexually transmitted infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 116
  • 118. Reflective Log – Sexually Transmitted Diseases 1. What did you do? Summarise the laboratory techniques used in the investigation of sexually transmitted infections. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 117
  • 119. 118
  • 120. 7.5 Infections in Pregnancy (Pre- and Post Delivery) 7.5a Diagnostic Algorithm Be able to describe the causes of viral infection in pregnancy, diagnostic investigations and control of infection. KNOWLEDGE • Know the range of viruses which may cause infections in pregnancy including: rubella, parvovirus, CMV, VZV • Understand other important non-viral infections in pregnancy e.g. toxoplasma gondii. • Know the common causes of viral infections in pregnancy and which range of investigations should be used for diagnostic testing and screening purposes. • Know the less common causes of viral infections in pregnancy and when to consider using investigations which may be used for diagnostic purposes. • Understand the requirements for appropriate samples from patients with potential virus infections in pregnancy such as urine, swabs, products of conception, acute and convalescent serum. • Understand the procedures involved in the collection of the above sample types and the optimal time for collection of various samples. • Understand any potential therapy which may be available for prophylaxis and treatment. of viral infections in pregnancy e.g. antivirals, immunoglobulin and vaccines. • Know which trimester patients are at highest risk with regard to specific virus infections. • Understand the implication of diagnostic test results on the counselling and management of patients from both clinical and patient viewpoints. • Know about infection controls issues and measures which may be taken with regard to virus infections in pregnancy in hospital and within the community. COMPETENCE You must be able to: a) Describe the range of viruses that may cause infection in pregnancy and investigations for diagnosis and screening. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how viral pathogens may cause infection in pregnancy and how patients with these infections would be managed and treated. 119
  • 121. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of viral infection in pregnancy, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of viral infections in pregnancy. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 120
  • 122. 7.5b Immunological Investigations Be able to perform serological techniques for the investigation of viral infection in pregnancy. KNOWLEDGE • Understand techniques available for the detection of viruses, viral antigen and viral antibody in pregnancy, including: o rapid test kits o immunofluorescence o complement fixation text o enzyme immunoassay o particle agglutination • Understand the advantages and disadvantages of the methods. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Describe the causes of enteric viral infections and relevant investigations for diagnosis. d) Refer specimens to a specialist centre in accordance with laboratory procedures. 121
  • 123. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of viral infection in pregnancy. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of viral infection in pregnancy. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 122
  • 124. 7.5c Molecular Techniques Be able to perform molecular techniques to the investigation of viral infection in pregnancy. KNOWLEDGE • Understand the requirements for appropriate samples from patients with suspected viral infection in pregnancy. • Understand the principles and limitations of molecular techniques available for diagnosis of viral infection in pregnancy. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 123
  • 125. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of viral infection in pregnancy in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of viral infection in pregnancy. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 124
  • 126. Reflective Log – Pregnancy (Pre- And Post- Delivery) 1. What did you do? Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 125
  • 127. 126
  • 128. 7.6 Neurological disease including Prion disease 7.6a Diagnostic Algorithm Understand the viral causes of neurological disease, diagnostic investigations and control of infection. KNOWLEDGE • Know the main viral causes of acute and chronic neurological disease, including meningitis, encephalitis, encephalopathies and dementia and how they are transmitted. • Know the most serious non-viral causes of neurological disease. • Understand the different mechanisms by which viruses affect the central nervous system (CNS). • Know the difference between encephalitis and meningitis. • Understand the principles for investigating possible viral causes for encephalitis and meningitis including: o Rabies and Lyssa virus o Herpes Simplex and other herpes viruses o Poliovirus o other enteroviruses and mumps. • Know which laboratory tests to perform to diagnose viral neurological disease. • Know which tests other pathology departments must perform on a CSF. • Know appropriate management and effective treatment for viral causes of neurological disease. COMPETENCE You must be able to: a) Describe the causes of viral neurological disease and investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how neurological disease viral pathogens may infect humans and how patients with these infections would be managed and treated. d) Describe which results chemistry tests can provide and their significance to a possible viral diagnosis. 127
  • 129. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the main viral causes of acute meningitis, encephalitis and encephalomyelitis and chronic neurological diseases, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list the possible viral causes of encephalitis and meningitis and identify the correct clinical specimens to collect in diagnosis. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating the pathogenesis and treatment of a neurological viral infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 128
  • 130. 7.6b Immunological and Molecular Techniques Be able to perform serological and molecular techniques to the investigation of neurological disease. KNOWLEDGE • Know which viral causes of neurological disease can be diagnosed serologically. • Understand the significance of paired sera in diagnosis of neurological disease. • Know the principles and limitations of immunological techniques available for the detection of neurological viral infections in samples. • Know which viral causes of neurological disease can be diagnosed using molecular techniques. • Understand the advantages and disadvantages of serological and molecular methods. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Describe the causes of enteric viral infections and relevant investigations for diagnosis. d) Refer specimens to a specialist centre in accordance with laboratory procedures. 129
  • 131. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of neurological infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of neurological infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 130
  • 132. 7.6c Electron Microscopy Be able to describe electron microscopy techniques for the investigation of neurological disease. KNOWLEDGE • Know which viral causes of neurological disease can be detected by electron microscopy and in which samples. • Know the diagnostic features of possible viral causes of neurological disease • Understand the principles and practice of electron microscopy techniques available for the detection of neurological viral infections in a variety of samples. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Be aware of internal and external quality procedures. COMPETENCE You must be able: a) Describe the application of electron microscopy to the investigation of neurological infections. b) Identify viral causes of neurological disease in electron micrographs. 131
  • 133. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of electron microscopy for the investigation of neurological viral infection. Date of completion: Trainer’s name: Trainer’s signature: ii) Listed the viral causes of neurological disease that can be detected by electron microscopy and in which clinical samples. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 132
  • 134. Reflective Log – Neurological Infections 1. What did you do? Summarise the laboratory techniques used in the investigation of neurological virus infections. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 133
  • 135. 134
  • 136. 7.7 Vesicular and Red Rashes and Systemic infections 7.7a Diagnostic Algorithm Understand the viral causes of vesicular and red rash and systemic infections, diagnostic investigations and control of infection. KNOWLEDGE • Know the common viral causes of vesicular and red rashes (including VZV, rubella, HHV6) and which panels of tests should be used for diagnostic testing. • Know which of the common viral causes of vesicular and red rashes may cause systemic infections and when additional diagnostic tests should be used. • Be aware of less common viral causes of vesicular and red rashes and when to consider using tests which may be used for diagnostic testing. • Be aware of less common viral causes of vesicular and red rashes may cause systemic infections and when extra diagnostic tests should be used. • Know the cyclical nature of viral pathogens that elicit vesicular and red rashes and the alert mechanisms used to establish when they should be investigated for and which tests to use. • Know the common and less common non-viral causes of vesicular and red rashes, and which may cause systemic infections. • Understand the requirements and procedures involved for collecting samples from patients with potential viral rash and systemic infections such as vesicle fluid, skin scrapings, nose and throat swabs, acute and convalescent serum. • Know the control of infection measures required to prevent laboratory, hospital and community-acquired infection from patients with a vesicular or red rash. • Know the first line treatment considerations used for patients with a vesicular or red rash, or patients with a systemic viral infection preceded by a vesicular or red rash. COMPETENCE You must be able to: a) Describe the causes of vesicular, red rash and systemic infections and investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how vesicular, red rash and systemic infections may infect humans and how patients with these infections would be managed and treated. 135
  • 137. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of vesicular, red rash and systemic infections, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of vesicular, red rash and systemic infections. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating the pathogenesis and treatment of a patient with a vesicular, red rash or systemic infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 136
  • 138. 7.7b Immunological Techniques Be able to perform serological techniques to the investigation of vesicular and red rashes; and systemic infections. KNOWLEDGE • Know the principles and limitations of immunological techniques available for the detection of viruses and antibodies from patients with rashes or systemic infections, including: o rapid test kits o immunofluorescence o complement fixation test o enzyme immyunoassay o particle agglutination • Understand the advantages and disadvantages of the methods. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Describe the causes of enteric viral infections and relevant investigations for diagnosis. d) Refer specimens to a specialist centre in accordance with laboratory procedures. 137
  • 139. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 138
  • 140. 7.7c Electron Microscopy and Cell Culture Be able to describe the principles and application of electron microscopy and cell culture techniques to the investigation of vesicular and red rash; and systemic infections. KNOWLEDGE • Understand the available EM and cell culture techniques available for the detection of viral infections causing rash or systemic infection. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Be aware of internal and external quality procedures. COMPETENCE You must be able to: a) Describe the application of electron microscopy to the investigation of viral infections causing rash or systemic infection. b) Recognise the morphology of the common viruses causing vesicular and red rash or systemic infection. 139
  • 141. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of electron microscopy for the investigation of vesicular and red rash or systemic infection. Date of completion: Trainer’s name: Trainer’s signature: ii) Listed the viral causes of causing vesicular and red rash or systemic infection that can be detected by electron microscopy and in which clinical samples. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 140
  • 142. 7.7d Molecular Techniques Be able to perform molecular techniques to the investigation of vesicular and red rash; and systemic infections. KNOWLEDGE • Understand the requirements for appropriate samples from patients with vesicular and red rash; and systemic infections. • Understand the principles and limitations of molecular techniques available for diagnosis of enteric viral infection. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 141
  • 143. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of vesicular and red rash; and systemic infections in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of vesicular and red rash; and systemic infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 142
  • 144. Reflective Log – Vesicular and Red Rashes; and Systemic Infections 1. What did you do? Summarise the laboratory techniques used in the investigation of vesicular and red rashes; and systemic infections. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 143
  • 145. 144
  • 146. 7.8 Blood-borne Virus Infections 7.8a Diagnostic Algorithm Understand the viral causes of Blood-borne virus infections, diagnostic investigations and control of infection. KNOWLEDGE • Understand the range of blood-borne viruses which may infect humans e.g. HIV, HTLV etc • Understand other important non-viral blood-borne infections e.g. malaria • Know the common causes of blood-borne virus infection and which range of investigations should be used for diagnostic testing and screening purposes. • Know the less common causes of blood-borne virus infection and when to consider using investigations which may be used for diagnostic purposes. • Understand any potential therapy which may be available for prophylaxis and treatment of blood-borne viral infections e.g. antivirals, immunoglobulin and vaccines. • Know which patient groups are at high risk with regard to blood-borne virus infections • Know the potential routes of infection by blood-borne viruses that are caused by human intervention. • Know the procedures that are put in place to prevent human to human transmission • Know about infection controls issues and measures which may be taken with regard to blood-borne virus infections in hospital and within the community. COMPETENCE You must be able to: a) Describe the causes of blood borne virus infections and investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how sexually transmitted viral pathogens may infect humans and how patients with these infections would be managed and treated. d) Describe the routes of transmission of blood borne viruses that are caused by human intervention. 145
  • 147. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of blood borne viral infections, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of blood borne viral infections. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating the pathogenesis and treatment of blood borne viral infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 146
  • 148. 7.8b Immunological Techniques Be able to perform serological techniques to the investigation of blood-borne virus infections. KNOWLEDGE • Understand techniques available for the detection of blood-borne viruses in samples, including: o rapid test kits o immunofluorescence o complement fixation test o enzyme immyunoassay o particle agglutination • Understand antigen detection techniques available for diagnosis of possible causal agent in samples. • Understand the requirement for confirmatory assays and the role of reference laboratories • Understand the advantages and disadvantages of the methods. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Describe the causes of enteric viral infections and relevant investigations for diagnosis. d) Refer specimens to a specialist centre in accordance with laboratory procedures. 147
  • 149. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 148
  • 150. 7.8c Molecular Techniques Be able to perform molecular techniques to the investigation of blood borne viruses. KNOWLEDGE • Understand the requirements for appropriate samples from patients with suspected blood-borne viral infections. • Understand the principles and limitations of molecular techniques available for diagnosis of blood-borne viral infections. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 149
  • 151. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of blood-borne viral infections in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of blood-borne viral infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 150
  • 152. Reflective Log – Blood Borne Viral Infections 1. What did you do? Summarise the laboratory techniques used in the investigation of blood borne viral infections. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 151
  • 153. 152
  • 154. 7.9 Investigation of Viral Hepatitis 7.9a Diagnostic Algorithm Be able to describe the causes of viral hepatitis, diagnostic investigations and control of infection. KNOWLEDGE • Understand the range of viruses which may cause liver disease. • Understand other important non-viral infections of the liver. • Know the common causes of viral liver infection and which range of investigations should be used for diagnostic testing and screening purposes. • Know the less common causes of viral liver infection and when to consider using investigations which may be used for diagnostic purposes. • Understand any potential therapy which may be available for prophylaxis and treatment of viral hepatitis e.g. antivirals, immunoglobulin and vaccines. • Know which patient groups are at high risk with regard to viral hepatitis • Know about infection controls issues and measures which may be taken with regard to viral hepatitis in hospital and within the community. COMPETENCE You must be able to: a) Describe the causes of viral hepatitis and investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how viral pathogens in hepatitis may infect humans and how patients with these infections would be managed and treated. 153
  • 155. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of viral hepatitis, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of viral hepatitis. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating the pathogenesis and treatment of viral hepatitis. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 154
  • 156. 7.9b Immunological Techniques Be able to perform serological investigations for viral hepatitis. KNOWLEDGE • Understand techniques available for the detection of viruses causing hepatitis in samples, including: o rapid test kits o immunofluorescence o complement fixation test o enzyme immyunoassay o particle agglutination • Understand antigen detection techniques available for diagnosis of possible causal agent in samples. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Understand the advantages and disadvantages of the methods. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Describe the causes of enteric viral infections and relevant investigations for diagnosis. d) Refer specimens to a specialist centre in accordance with laboratory procedures. 155
  • 157. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 156
  • 158. 7.9c Molecular Techniques Be able to perform molecular techniques to the investigation of viral hepatitis infections. KNOWLEDGE • Understand the requirements for appropriate samples from patients with suspected viral hepatitis. • Understand the principles and limitations of molecular techniques available for diagnosis of enteric viral infection. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 157
  • 159. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of viral hepatitis in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of viral hepatitis. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 158
  • 160. Reflective Log – Viral Hepatitis 1. What did you do? Summarise the laboratory techniques used in the investigation of viral hepatitis. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 159
  • 161. 160
  • 162. 7.10 Infections in Neonates and Infants 7.10a Diagnostic algorithm Be able to describe the viral causes of infections in neonates and infants (including sudden unexpected deaths), diagnostic investigations and control of infection. KNOWLEDGE • Understand the range of viruses which need to be ruled out in neonates and infants dying of SUDI e.g. RSV, enteroviruses. • Understand other important non viral infections which have been linked to neonates and infants as a cause of SUDI. • Know the common causes of infection in neonates/ infants and which range of investigations should be used for diagnostic purposes. • Know the less common causes of infection in neonates/infants and when to consider using investigations which may be used for diagnostic purposes. • Understand the importance of obtaining a relevant clinical history of the patient and mother if appropriate. • Understand the requirements for appropriate samples from patients according to clinical syndrome. • Understand the requirement to communicate with other pathology disciplines in the case of SUDI to direct appropriate investigation selection. • Understand potential therapy which may be available for prophylaxis and treatment of these infections e.g. antivirals, immunoglobulin and vaccines. • Know about infection controls issues and measures which may be taken with regard to these infections. • Know the potential infection risk posed to the neonate. COMPETENCE You must be able to: a) Describe the causes of neonatal and paediatric infections and investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how neonatal and paediatric viral pathogens may infect humans and how patients with these infections would be managed and treated. 161
  • 163. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of neonatal and paediatric infections, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of neonatal and paediatric infections. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating the pathogenesis and treatment of a neonatal viral infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 162
  • 164. 7.10b Immunological Techniques Be able to perform serological investigations for the diagnosis of viral infections in neonats and infants. KNOWLEDGE • Understand the potential use of stored antenatal samples from mother in diagnostic investigations. • Understand the requirements for appropriate samples from patients according to clinical syndrome. • Know the principles and limitations of immunological techniques available for the detection of enteric viral infections in samples, including: o rapid test kits o immunofluorescence o complement fixation test o enzyme immyunoassay o particle agglutination • Understand antigen detection techniques available for diagnosis of possible causal agent in samples. • Understand the requirement for confirmatory assays and the role of reference laboratories • Understand the advantages and disadvantages of the methods. • Understand the predictive value of various assays in different population groups. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Refer specimens to a specialist centre in accordance with laboratory procedures. 163
  • 165. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 164
  • 166. 7.10c Electron Microscopy and Cell Culture Be able to describe the principles and application of electron microscopy and cell culture techniques to the investigation of infections in neonates and infants, including sudden unexpected deaths. KNOWLEDGE • Understand the principles and practice of electron microscopy techniques available for the investigation of infections in neonates and infants. • Understand the use of cell culture techniques available for diagnosis of possible causal agent in samples. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Be aware of internal and external quality procedures. COMPETENCE You must be able: a) Describe the application of electron microscopy to the investigation of infections in neonates and infants. b) Recognise the morphology of the common viruses causing infection in neonates and infants. 165
  • 167. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of electron microscopy and cell culture for the investigation of infection on neonates and infants. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 166
  • 168. 7.10d Molecular Techniques Be able to perform molecular techniques to the investigation of infections in neonates and infants including sudden unexpected deaths. KNOWLEDGE • Understand the requirements for appropriate samples from neonates or infants with suspected viral infection. • Understand the principles and limitations of molecular techniques available for diagnosis of viral infection. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 167
  • 169. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of infections in neonates and infants in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of infections in neonates and infants. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 168
  • 170. Reflective Log – Neonates and Infants 1. What did you do? Summarise the laboratory techniques used in the investigation of viral infections in neonates and infants. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 169
  • 171. 170
  • 172. 7.11 Immunocompromised Patients 7.11a Diagnostic algorithm Understand the viral causes of infections in immunocompromised patients, diagnostic investigations and control of infection. KNOWLEDGE • Understand the cause of primary and secondary immunodeficiency, including: o viral o hereditary o physiological i.e. the 4 hypersensitivity types o drug induced following medical or surgical treatment • Understand the range of viruses which may infect immunocompromised patients e.g. JC, BK virus. • Understand other important non-viral infections in immunocompromised patients. • Know the common causes of viral infections in immunocompromised patients and which range of investigations should be used for diagnostic testing and screening purposes. • Know the less common causes of viral infections in immunocompromised patients and when to consider using investigations which may be used for diagnostic purposes. • Understand potential therapy which may be available for prophylaxis and treatment of infections in immunocompromised patients, including antivirals, immunoglobulin and vaccines. • Know about infection controls issues and measures which may be taken with regard to these infections. • Know the potential infection risk posed to immunocompromised patients. COMPETENCE You must be able to: a) Describe the causes of viral infections in immunocompromised patients and investigations for diagnosis. b) Explain factors that should be taken into consideration when selecting an investigation. c) Describe how immunocompromised patients with infections would be managed and treated. 171
  • 173. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of infection in immunocompromised patients, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors which should be taken into consideration when selecting techniques for the investigation of immunocompromised patients. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating an example of viral infection in an immunocmpromised patient. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 172
  • 174. 7.11b Immunological investigations Be able to perform serological techniques to the investigation of infections in immunocompromised patients. KNOWLEDGE • Know the principles and limitations of immunological techniques available for the detection of viral infections in immunocompromised patients, including: o rapid test kits o immunofluorescence o complement fixation test o enzyme immyunoassay o particle agglutination • Understand antigen detection techniques available for diagnosis of possible causal agent in samples. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Understand the advantages and disadvantages of the methods. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. c) Refer specimens to a specialist centre in accordance with laboratory procedures. 173
  • 175. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform investigations in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: iii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 174
  • 176. 7.11c Electron Microscopy and Cell Culture Techniques Be able to describe electron microscopy and cell culture techniques for the investigation of infections in immunocompromised patients. KNOWLEDGE • Understand the principles and practice of electron microscopy and cell culture techniques available for the detection of infections in immunocompromised patients. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Be aware of internal and external quality procedures. COMPETENCE You must be able: a) Describe the application of electron microscopy and cell culture to the investigation of immunocompromised patients. b) Recognise the morphology of the common viruses found in immunocompromised patients. 175
  • 177. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of electron microscopy for the investigation of immunocompromised patients. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 176
  • 178. 7.11d Molecular Techniques Be able to perform molecular techniques to the investigation of infections in immunocompromised patients. KNOWLEDGE • Understand the requirements for appropriate samples from immunocompromised patients. • Understand the principles and limitations of molecular techniques available for diagnosis of viral infection. • Understand the requirement for confirmatory assays and the role of reference laboratories. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Perform techniques in accordance with standard laboratory procedures. b) Critically evaluate results and report in accordance with laboratory procedures. 177
  • 179. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Observed by trainer to perform molecular investigations of immunocompromised patients in accordance with standard laboratory procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of immunocompromised patients. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 178
  • 180. Reflective Log – Immunocompromised Patients 1. What did you do? Summarise the laboratory techniques used in the investigation of immunocompromised patients. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 179
  • 181. 180
  • 182. 7.12 Travel Related and Exotic Infections. 7.12a Diagnostic Algorithm Be able to describe the viral causes of travel related and exotic infections, diagnostic investigations and control of infection. KNOWLEDGE • Know the main causes of viral infections likely to have been acquired in unusual circumstances or outside of the UK, including arboviruses, filoviruses, arenaviruses, hantaviruses, rhabdoviridae, enteroviruses. • Know the appropriate laboratory diagnosis for each virus listed. • Know the risk factors, patient history and clinical symptoms which would indicate a possible travel related or exotic infection. • Know what information can be obtained from examination of bites and wounds and how that contributes to diagnosis of travel related and exotic infections. • Know the groups of virus transmitted via animal bites and insect bites. • Know the important bacterial and parasitic causes of serious illness associated with travel and exotic infections. • Know the hazards of laboratory acquired infection with such viral, bacterial and parasitic pathogens. • Know how arboviruses, filoviruses, arenaviruses, hantaviruses, rhabdoviridae, enteroviruses are transmitted. • Know what control measures are required to prevent or limit the spread of these viruses. • Be aware of how economic and political factors affect spread and control of these infections. • Be aware of how a patient suspected of infection with a travel related or exotic infection would be managed in the UK COMPETENCE You must be able to: a) List the major viruses viral causes of travel related and exotic infections. b) Describe the information that would lead to a suspicion that a patient was infected with each of these viruses. c) Name the important bacteria and parasites that could also be implicated in travel related and exotic infections. d) Describe the procedure for diagnosing infection with these pathogens, including where specimens should be sent for specialised tests and how specimens would be transported to a reference laboratory. e) Describe how the most dangerous travel related and exotic viral infections are transmitted. f) Explain how spread of these infections would be controlled or limited. 181
  • 183. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by trainer on the causes of travel related or exotic viral infections, investigations for diagnosis and treatment of infected patients. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of factors that should be taken into consideration when selecting techniques for the investigation of travel related or exotic viral infections. Date of completion: Trainer’s name: Trainer’s signature: iii) Described a case study illustrating the pathogenesis and treatment of an arboviral infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 182
  • 184. 7.12b Immunological investigations Be able describe serological techniques for the investigation of travel related and exotic infections. KNOWLEDGE • Know the serological tests currently available for arboviruses, filoviruses, arenaviruses, hantaviruses, rhabdoviridae, enteroviruses and which are available in a routine diagnostic virology department. • Know the type of serological test in each case, whether the procedure detects antigen or antibody and whether paired sera are required. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) List the serological tests currently available for arboviruses, filoviruses, arenaviruses, hantaviruses, rhabdoviridae, enteroviruses and in each case name the laboratory where they would be carried out. b) Give details of the quality assurance procedures used in the serological tests described. 183
  • 185. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of the advantages and disadvantages of the techniques available for the investigation of infection. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 184
  • 186. 7.12c Electron Microscopy Techniques Be able to describe electron microscopy techniques to the investigation of travel related and exotic infections. KNOWLEDGE • Know which viruses associated with travel and exotic infections can be detected by electron microscopy. • Know at which stage in the infection this is an appropriate diagnostic method in each case. • Know in which specimen(s) virus can be detected for each infection. • Know the hazards to laboratory staff of processing specimens from patients with travel related and exotic infections for electron microscopy. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) List the viruses associated with travel and exotic infections which can be detected by electron microscopy. b) Correctly identify the appropriate specimen(s) and at which stage in the infection they can be collected in each case. c) Describe the hazards associated with handling specimen specimens from patients with travel related and exotic infections for electron microscopy and the precautions required in the laboratory. d) Give details of the quality assurance procedures used in electron microscopy 185
  • 187. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of electron microscopy for the investigation of travel and exotic infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 186
  • 188. 7.12d Molecular Techniques Be able to describe molecular techniques to the investigation of travel related and exotic infections. KNOWLEDGE • Know the molecular techniques currently available for the detection of viruses associated with travel and exotic infections. • Know at which stage in the infection this is an appropriate diagnostic method in each case. • Know in which specimen(s) viral antigen can be detected by molecular methods for each infection. • Know the hazards to laboratory staff of applying molecular techniques to specimens from patients with travel related and exotic infections. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) List the viruses associated with travel and exotic infections which can currently be detected by molecular techniques. b) Describe the principles behind each test. c) Correctly identify the appropriate specimen(s) and at which stage in the infection they can be collected in each case. d) Describe the hazards associated with applying molecular methods to specimens from patients with travel related and exotic infections and the precautions required in the laboratory. e) Give details of the quality assurance procedures used in these molecular techniques. 187
  • 189. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of molecular techniques available for the investigation of travel and exotic infections. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 188
  • 190. Reflective Log – Travel and Exotic Infections 1. What did you do? Summarise the laboratory techniques used in the investigation of travel and exotic infections. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 189
  • 191. 190
  • 192. 7.13 Infection Control 7.13a Infection Control Procedures Be able to describe the principles and practice of infection control procedures. KNOWLEDGE • Understand the principles of control of infection are based on: o removal of sources e.g. decontamination of equipment o blocking of routes of spread e.g. isolation, hand washing etc o enhancing resistance of patient e.g. immunisation, prophylaxis • Know the relevant infection control procedures within the laboratory. • Be aware of the activities of the hospital infection control team (ICT) and know where to reference their guidelines. • Know the importance of infection control in the hospital setting e.g. RSV or rotavirus on paediatric wards. • Know the different infection control methods available to prevent transmission of infection. • Know how to produce and collate virology tests and results in order to help epidemiological investigations to support infection control in the hospital. • Know the importance of infection control in the community setting. • Be aware of the role of the CCDC (Consultant for Communicable Disease Control). COMPETENCE You must be able to: a) Describe the principles of infection control. b) Describe the infection control procedures used in the laboratory, hospital and community. c) Produce and collate virology tests and results for epidemiological investigations to support infection control in the hospital. d) Describe the roles and responsibilities of the laboratory, ICT and CCDC. 191
  • 193. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of infection control procedures. Date of completion: Trainer’s name: Trainer’s signature: ii) Produced a list of viruses that pose infection control problems in the hospital and community. Date of completion: Trainer’s name: Trainer’s signature: iii) Written a short essay comparing on the role and responsibilities of laboratory, ICT and CCDC. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 192
  • 194. Reflective Log – Infection Control 1. What did you do? Summarise the role of the laboratory in infection control. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 193
  • 195. 194
  • 196. 7.14 Application of pre and post exposure prophylaxis and vaccination in virology 7.14a Principles of pre and post exposure prophylaxis Be able to describe the principles of pre and post exposure prophylaxis. KNOWLEDGE • Understand the principles of and strategies for the use pre-exposure prophylaxis. • Understand the biological mechanisms of pre-exposure prophylaxis. • Understand the principles of and strategies for the use post-exposure prophylaxis prophylaxis. • Understand the biological mechanisms of post-exposure prophylaxis. COMPETENCE You must be able to: demonstrate KNOWLEDGE of: a) Can describe the main uses of pre-exposure prophylaxis. b) Can describe the goals and limitations of pre-exposure prophylaxis. c) Can describe the main uses of post-exposure prophylaxis. d) Can describe the goals and limitations of post-exposure prophylaxis 195
  • 197. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of principles of and strategies for the use pre-and post exposure prophylaxis. Date of completion: Trainer’s name: Trainer’s signature: ii) Written a short essay comparing on use pre-and post exposure prophylaxis. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 196
  • 198. 7.14b Principles of vaccination Understand the principles and application of vaccination. KNOWLEDGE • Understand the principles of and strategies for using vaccination. • Understand the biological mechanisms of active immunisation. • Understand the biological mechanisms of passive immunisation. • Understand the need for childhood vaccination. • Understand the principle of the UK Childhood vaccination strategy. • Understand the WHO global immunisation policy. • Understand the principles of herd immunity. • Understand the need for targeted vaccination e.g. HBV in prisons. • Know which vaccinations are available for health care workers and why. • Be aware of the statutory regulations regarding health care workers and vaccination. COMPETENCE You must be able to: Demonstrate KNOWLEDGE of: a) Can describe how vaccination works. b) Can describe the goals and limitations of active immunisation. c) Can describe the goals and limitations of passive immunisation. d) Describe the legal requirements of HCW vaccinations in accord with European Directive (2000/54/EC); in the UK vaccination is currently recommended. 197
  • 199. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of immunisation strategies and procedures, including those applicable to healthcare workers. Date of completion: Trainer’s name: Trainer’s signature: ii) Written a short essay comparing goals and limitations of active and passive immunisation. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 198
  • 200. 7.14e Indications for vaccination in the general community Understand the indications for vaccination in the general community. KNOWLEDGE • Understand the need for childhood vaccination • Understand the principle of the UK Childhood vaccination strategy • Understand the WHO global immunisation policy • Understand the principles of herd immunity • Understand the need for targeted vaccination e.g. HBV in prisons COMPETENCE You must be able to demonstrate KNOWLEDGE of: a) Can describe the goals and limitations of childhood vaccination. b) Can describe the goals and limitations of WHO global immunisation policy. c) Can describe the goals and limitations of targeted vaccination schemes. 199
  • 201. EVIDENCE OF ACHIEVEMENT Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 200
  • 202. Reflective Log – Pre and Post Exposure Prophylaxis and Vaccination 1. What did you do? Summarise the laboratory role in prophylaxis and vaccination. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 201
  • 203. 202
  • 204. 7.15 Application of methods for antiviral treatment and resistance in virology 7.15a Principles of anti viral therapy Be able to describe the principles of anti viral therapy. KNOWLEDGE • Understand the strategy for the development of antiviral agents. • Understand the variety of processes by which antiviral agents target the virus. • Know of the clinical application of the most widely used antiviral agents in areas such as prophylaxis, reactivation, prevention of complications and treatment of acute disease. • Know of the clinical application of antiviral agents in long term therapy of chronic infections and in immunocompromised patients. COMPETENCE You must be able to: Demonstrate KNOWLEDGE of: a) Describe Know what the anti-viral agents are currently available and what their mode of action is. b) Describe when, where and why antiviral agents are used. 203
  • 205. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of anti viral therapy. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 204
  • 206. 7.15b Principles of viral load monitoring Be able to describe Understand the principles of viral load monitoring. KNOWLEDGE • Understand the importance and relevance of monitoring viral load in some infections. • Understand the relevance of emergence of drug resistant mutants in the treatment of patients on long term therapy. • Understand the techniques available for measuring viral load such as target. amplification (e.g. PCR, TMA) and signal amplification (e.g. bDNA). • Know the relevant internal and external quality procedures. COMPETENCE You must be able to demonstrate KNOWLEDGE of: a) Describe the importance of viral load monitoring. b) Describe when, where and viral load monitoring is used. c) Confirm sample type is appropriate to the investigation being requested, if not, take appropriate action. d) Perform sample preparations steps relevant to the investigation and following the appropriate SOP’S. e) Demonstrate the ability to carry out the majority of the techniques listed above f) Demonstrate the ability to consider all relevant factors that should be taken into account when selecting a test. g) Demonstrate the ability to interpret results of the tests above with the awareness of the advantages and disadvantages of each method and in conjunction with the internal quality control results. h) Demonstrate the ability to refer specimens to a specialist centre if required. 205
  • 207. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of viral load monitoring. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 206
  • 208. 7.15c Principles of anti viral resistance testing Be able to describe Understand the principles of anti viral resistance testing. KNOWLEDGE • Understand the relevance of emergence of drug resistant mutants in the treatment of patients on long term therapy. • Understand the techniques available for resistance testing using molecular sequencing including gel and capillary based and cell culture techniques for genotype and phenotype resistance. • Know the relevant internal and external quality procedures. COMPETENCE You must be able to: a) Describe the importance of anti viral resistance testing. b) Describe the techniques principles ands practice of the techniques available for resistance testing. You must be able to demonstrate KNOWLEDGE of: c) Confirm sample type is appropriate to the investigation being requested, if not, take appropriate action. d) Perform sample preparations steps relevant to the investigation and following the appropriate SOP’S. e) Demonstrate the ability to carry out the majority of the techniques listed above. f) Demonstrate the ability to consider all relevant factors which should be taken into account when selecting a test. g) Demonstrate the ability to interpret results of the tests above with the awareness of the advantages and disadvantages of each method and in conjunction with the internal quality control results. h) Demonstrate the ability to refer specimens to a specialist centre if required. 207
  • 209. EVIDENCE OF ACHIEVEMENT This section requires the trainer to sign that the specialist practitioner in training has successfully achieved the level of competence on more than one occasion. The practitioner should collect and prepare other supporting evidence as a portfolio. i) Answered questions set by the trainer on the principles and practice of viral resistance testing. Date of completion: Trainer’s name: Trainer’s signature: Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 208
  • 210. Reflective Log – Antiviral Treatment and Resistance 1. What did you do? Summarise the main points of the techniques used in the laboratory in the performance of urinary analysis. Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 209
  • 211. 210
  • 212. 7.16 Application of methods for investigation of environmental samples for virology 7.16a River and water samples Understand the scope of and the methods used for river and water samples. KNOWLEDGE • Understand the requirements for appropriate samples from river, sea, lakes and drinking water sources. • Understand the procedures involved in the collection of the above sample types • Must also have an Understanding of optimal time for collection of various samples. • Know the available methods, both standard and research that can be used to investigate water samples for the presence of virus • Know the analytical limitations of the above • Know the relevant internal and external quality procedures COMPETENCE You must be able to demonstrate KNOWLEDGE of: a) List the viruses associated with river and water samples that can currently be detected by standard and research techniques. b) Describe the principles behind each test. c) Correctly identify the appropriate sample(s) and when and where they can be collected dependent on the investigation. d) Describe the hazards associated with applying methods to river and water samples and the precautions required in the laboratory. e) Give details of the quality assurance procedures used in these techniques. 211
  • 213. EVIDENCE OF ACHIEVEMENT Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 212
  • 214. 7.16b Food samples Understand the scope of and the testing methods for food samples. KNOWLEDGE • Understand the requirements for appropriate samples from different food types including monitoring and outbreak investigations. • Understand the procedures involved in the collection of the above sample types • Must also have an Understanding of optimal time for collection of various samples. • Know the available methods, both standard and research that can be used to investigate food samples for the presence of virus • Know the analytical limitations of the above • Know the relevant internal and external quality procedures COMPETENCE You must be able to demonstrate KNOWLEDGE of: a) List the viruses associated with food samples that can currently be detected by standard and research techniques. b) Describe the principles behind each test. c) Correctly identify the appropriate sample(s) and when and where they can be collected dependent on the investigation. d) Describe the hazards associated with applying methods to food samples and the precautions required in the laboratory. e) Give details of the quality assurance procedures used in these techniques. 213
  • 215. EVIDENCE OF ACHIEVEMENT Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 214
  • 216. 7.16c Air and aerosol sampling Understand the scope of and the testing methods for air and aerosol sampling. KNOWLEDGE • Understand the requirements for appropriate samples from the air including ‘clean air’ and environmental sources and from man made and environmental aerosol sources. • Understand the procedures involved in the collection of the above sample types • Must also have an understanding of optimal time for collection of various samples. • Know the available methods, both standard and research that can be used to investigate air and aerosol samples for the presence of virus • Know the analytical limitations of the above • Know the relevant internal and external quality procedures COMPETENCE You must be able to demonstrate KNOWLEDGE of: a) List the viruses associated with air and aerosol samples that can currently be detected by standard and research techniques. b) Describe the principles behind each test. c) Correctly identify the appropriate sample(s) and when and where they can be collected dependent on the investigation. d) Describe the hazards associated with applying methods to air and aerosol samples and the precautions required in the laboratory. e) Give details of the quality assurance procedures used in these techniques. 215
  • 217. EVIDENCE OF ACHIEVEMENT Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 216
  • 218. 7.16d Testing procedures to detect the presence of fomites Understand the scope of and the testing methods for fomites. KNOWLEDGE • Understand the requirements for appropriate samples for the detection of fomites • Understand the procedures involved in the collection of the above sample type • Must also have an Understanding of optimal time for collection of various samples. • Know the available methods, both standard and research that can be used to investigate inanimate samples for the presence of virus • Know the analytical limitations of the above • Know the relevant internal and external quality procedures COMPETENCE You must be able to demonstrate KNOWLEDGE of: a) List the viruses associated with inanimate samples that can currently be detected by standard and research techniques. b) Describe the principles behind each test. c) Correctly identify the appropriate sample(s) and when and where they can be collected dependent on the investigation. d) Describe the hazards associated with applying methods to inanimate samples and the precautions required in the laboratory. e) Give details of the quality assurance procedures used in these techniques. 217
  • 219. EVIDENCE OF ACHIEVEMENT Portfolio and evidence of competence for this standard assessed and passed by: Assessor’s signature: Assessor’s name: Date: 218
  • 220. Reflective Log – 1. What did you do? Date(s). Duration of training. 2. What did you learn? 3. How have you applied or will you apply the learning in your future work? Future development possibilities. 219